. 5 



HEALTH 
BULLETIN 

FOR TEACHERS 

fl *I f fl 



Issued by the State Health 
Department of Oklahoma 



Dr. A. R. Lewis, 
State Commissioner of Health 



i^ov ' 6 1928 



;5 



^' 






PRINTED BY 
THE AMERICAN PRINTING <S 
MUSKOGEE, OKLAHOMA 







J. B. A. ROBERTSON 

If the question were asked me, "What is the .f P^'^.^^^f ^;f^Vi^!i! 
Citizens of Oklahoma?" my reply would be not cil, not ^^^ ' not abun 
dant crops, not splendid highways, ^ot"i_^gnificent buildings but 
physical HEALTH. Given health any individual can hew his ^^ay to 
^^^^^^^- —Govemor J. B. A. Robertson. 



He who helps a child helps humanity with 
a distinctness, with an immediateness, 
which no other help given to human crea- 
tures in any stage of their human life can 
give. — Phillip Brooks. 




To salvaj^e lives from the un- 
dertow of disease and ignorance; 
to so improve conditions that 
the children of Oklahoma may 
have a better chance for health 
and efficiency, is the desire 
that stands out preeminent in 
the conduct of the State Health 
Department. — Dr. A. R. Le^vis. 



Dr. A. R. Lewis. 



All development of the human 
race has been by a process of 
education. Education proper 
consists of three main elements 
— the mental, the moral and the 
physical. The schools have al- 
ways sought to develop the 
mental faculties; the church is 
devoted to the development of 
the moral and the spiritual fac- 
ulties; but thus far we have fail- 
ed in any organized effort to 
protect and develop the physi- 
cal faculties. — R. H. Wilson. ^ 




R. H. Wilson. 



INDEX 



Foreword to Teachers „ 8 

Introduction _ 9 — 10 

Public Service Quotations _ 10 

Medical Inspection of Schools 11 

State Should Assist in Removing Defects _ 11 

Defects Cause Retardation 11 

Right of State to Compel Medical Inspection 11 

Japan's System of Medical Inspection 11 

System of Inspection Favored 12 

Argument in Favor of Inspection _ 12 

Childx'en Should Have as Careful Attention Physically as 

Mentally 12 

How Inspection Could be Brought About 13 

Other Reasons for Health Supervision of Schools 13 

An Illustration in Point 13 — 14 

Aid to State Health Department 14 

Records in Medical Inspection 14 

The School Nurse 14-18 

Health Rules for Children 18 

Diseases of Children 19 

Measles 19—20 

Whooping Cough 20—21 

Diphtheria 21—22—23 

Scarlet Fever 23—24 

Chickenpox 24 

Colds 24 

Health Quotations - - 25 

For Promoting Health and Efficiency in the Small Tov/n and 

Rural Schools 25 

Need of Higher Standard 25 

Where State Funds Should be Applied _ _ 26 



INDEX 

C o n t i n u e d 

Modern Schoolhouses for Rural Communities 26 

Domestic Science Dept. in Every School _ 26 

School Hygiene _ _..27 

Unwashed hands Spread Disease _ 27 

Attention to Toilets 27 

School Furniture _ _ 27 

Vision and Hearing Tests - 28 

To Test the Eyesight „ 28 

To Test The Hearing 29 

Free Text Books , 29 

To Keep Well _ „ _ 29—30 

Suggestions to Teachers and School Physicians with Reference v 

to Medical Inspection — Infectious Diseases 30 — 31 \ 

The Eyes - - - 31 

The Ears 31 

The Throat and Nose _ - 31 

Disease of the Skin _ 1 ...32—33 

Diseases of the Bones and Joints _ _ 33 

General Symptons Teacher Should Notice 33 — 34 

The Teeth _ „ „ „ _ 34—35 

Nervous and Mental Defects 35—36—37 

Teaching Health _ _...._ 38 

Be Healthy Yourself _ ...38 

How You Can Teach Health 38—39 

Teaching Health in The Kindergarten 39 

Food Teaching in Primary Grades - 39 

Health Correlation With Studies in Intermediate Grades 40 

Aims of the State Health Department 41 

Postcard _ - - _ 42 

Letter of Endorsement _ 43 



FOREWORD TO TEACHERS 



To promote health and efficiency in schools; to bring- 
about better conditions under which the teacher must 
perform her duties; and to further the work of the 
Health Conservation Crusade, please fill out care- 
fully and mail the post card found in this bulletin, 
at the expiration of the first month of your schooL 



INTRODUCTORY 



Why is the subject of health now occupying the center of the 
stage for all thinking people? Because health, or the lack of it, so 
vitally affects the destiny of nations. Because sickness disrupts eco- 
nomic conditions. Because ill health impairs the physical fitness and 
efficiency of the individual; detracts and cripples his usefulness. The 
moral, the social, the economic, and the political future of our state, 
as well as that of our nation, is dependent upon the health of the 
people. 

Habit determines destiny. The most miserable of human beings 
is one in whom nothing is habitual but indecision. All is habit in 
mankind. The power of habit is so great that the question of success 
in life hinges upon the early formation of good habits; and to 
realize the connection between health and habit is a crying need today. 

I am therefore unable to emphasize, as should be emphasized, 
the monumental importance of constant, continuous and persistent drill 
ing into children habits of health and personal cleanliness. "Train 
up a child in the way he should go and when he is old he will not de- 
part from it" has lost none of its striking significance in these modern 
times. 

Health Habits are the War Savings Stamps and the Disease Risk 
Insurance of youth, bearing a usury rate of interest compound semi- 
annually, which may be disposed of at a premium in middle life and 
old age. 

Oklahoma cannot wrap about her a more impenetrable armor of 
protection, nor render a greater service to posterity than to under- 
write the health of her future citizenship with education and preven- 
tion. 

People in all stations of life are beginning to sense the colossal 
importance of finding a remedy for the sickness problem. This is 
significantly evidenced by the introduction in Congress last February 
of a bill providing "for the promotion of physical education in the 
United States through co-operation with the different states in the 
preparation and payment of s>:.pervisors and teachers of physical ed- 
ucation, including imedical examiners and school nurses." 

Physical education, within the meaning of this act, is to fully 
and thoroughly prepare boys and girls of this nation for the duties 
and responsibilities of citizenship through the development of bodily 
vigor and endurance, muscular strength and skill, bodily and mental 
poise, etc. 

Recent convictions for violation of the Oklahoma Venereal Disease 
Law is also strikingly significant of the times. Surely, civilization 
is making progress when the law takes cognizance of the violation of 
the laws, and more particularly is such progress apparent when the 
courts enforce such laws. 

A question that is forcing itself with greater insistence on the* 
minds of educators and scientific men today is not how many, but how 
few diseases are not the consequences of man's ignorance, indifference, 
self-indulgence and lack of early education. 

Therefore it is meet and proper that our law-making bodies should 
enact laws for the protection of the children against the spread and 
transmission of disease, and for the development of physical strength 
and endurance. 

The signs of the times are unmistakable that in all civilized coun- 
tries the era of preventive medicine has dawned. Granting the great 

9 



Importance of curative measures, we are beginning- to see clearly that 
prevention is the paramount weapon in the war against disease; that 
no other weapon is so effective against the occurrence of contagious 
and communicable disease and that nothing so restricts their spread. 
Morover, to provide hygienic and sanitary conditions everywhere is to 
create and build up a healthy race. 

Every child is entitled to its natural birthright of health and 
longevity. 

The efficiency of a nation depends upon the health of its people. 
That it is impossible for any individual, state or nation to really 
achieve great things without good health, is being recognized by edu- 
cators and by progressive men who think, ever;^^vhere. R. H. Wilson, 
State Superintendent of Public Instruction has just announced that, in 
lieu of other school work, time devoted to the Health Crusade, soon 
to be launched by the State Health Department and the Oklahoma 
Public Health Association, will be allowed credits. 

Primarily, then, the mission of this little booklet is fourfold : 

1st. To bring to the teacher a few simple directions for the pre- 
vention and spread of diseases in school. 

2nd. To outline symptons of children's diseases that the teacher 
or parent may know the first danger signals and be prepared to act. 

3rd, To, enlist the aid and help of teachers in the spreading of 
health propaganda into every home, and the teaching of health habits 
to every child in Oklahoma. 

4th. To solicit and earnestly request the co-operation of teachers 
In a campaign for better schools and a cleaner, healthier state. 



Public Service Quotations 

The noblest motive is the public good. — Virgil. 

Public safety is the supreme law. — Bacon. 

The health of the people is of supreme importance. — Chester A. 
Arthur. 

There is something better than making a living — ^making a life. — 
Lincoln. 

When a man assumes a public trust, he should consider himself as 
public property. — Thomas Jefferson. 

To raise the level of national health is one of the surest ways of 
raising the national happiness. — Lecky. 

The whole sum of life is service — service to others and not to 
self. No man has come to greatness who has not felt in some de- 
gree that his life in some degree belongs to the race. — Brooks. 

Men who are occupied in the restoration of health of others, by 
joint exertion of skill and humanity are above all, the great of the 
earth. They even partake of the Divinity, since to preserve and renew 
is almost as noble as to create.— Voltair. 

10 



Medical Inspection of Schools 

In the ceaseless mark of progress Oklahoma is lagging behind 
many of the other states in a matter which I consider of vital and 
far-reaching importance — that of medical inspection of schools. 

No where on the statute books of this state do we find a law 
relating to medical supervision of schools. While a few of o\:»>r larger 
and more progressive cities and towns have the advantages and bene- 
fits of such health supervision and a public health nurse, the schools 
in the smaller towns and rural communities are entirely without pro- 
tection in this particular. 

STATE SHOULD ASSIST IN REMOVING DEFECTS. 

Oklahoma has a compulsory educational law which provides that 
all children between the ages of eight and eighteen years shall at- 
tend school for a certain number of months each year. This is a gool 
law and a step foi*ward in progress. But justice and equity de- 
mand that if a state compels a child to attend school, it should go fur- 
ther and assist the child to overcome and remove any defects an^l ob- 
stacles that might retard its progress. 

The child has a claim upon the state and the state has a claim 
upon the child which demand recognition, and which cannot be ig- 
nored without haiTnful results to both. 

DEFECTS CAUSE RETARDATION. 

We are beginning to find out that many of our backward pupik 
are backward because of physical defects which render them unable 
to handle the work of the program. What these defects are and the 
causes that lie behind them are the things that we must know. If we 
do not know them w^e must find them out and guard against them. 
Education without health is futile. It is far better to sacrifice ed- 
ucation if, in order to attain it, the child must lay down his health as 
the price. 

RIGHT OF A STATE TO COMPEL MEDICAL INSPECTION, 

The objection that the state has no right to require medical in- 
spection of school children is not well taken. The duty to see that 
no harm comes to those who go to school devolves upon the authority 
compelling attendance. 

When this subject is considered both from the standpoint of the 
individual and the state, we wonder that medical inspection of schools 
was not put into effect long ago. The well-being of a state is as muek 
dependent upon the health strength and productive capacity of 
its citizenship, as upon their knowledge and intelligence. And tiie ef- 
ficiency of the individual cannot endure upon a foundatioh of educa- 
tion and intelligence alone, but the very comer-stone of the founda- 
tion must rest upon health and vigor. Therefore, if the state may 
make mandatory training in intelligence, it may also compel training 
to secure physical soundness and capacity. 

JAPAN'S SYSTEM OF MEDICAL INSPECTION. 

We are told that Japan has a system of medical inspection that 
reaches the most remote rural sections. By this method of inspec- 
tion the Department of Education of that country is able to tell how 
many children are in school in the whole Empire, how many are ro- 
bust and vigorous, medium, or weak; how many have defective hearing 
and eyesight, and what diseases are most prevalent at different ages 
of school life. 

11 



SYSTEMS OF INSPECTION FAVORED. 

I do not favor any system that would lessen the responsibility of 
the parent or tend in any way to weaken or supersede the home. But 
I am most earnestly in favor of a system of inspection that will 
acquaint the parent with the needs of his child of which he would 
otherwise be ignorant. 

ARGUMENT IN FAVOR OF INSPECTION. 

A logical arp,ument in favor of medical inspection of schoo^s from 
a financial standpoint, it seems to me, is that of the repeater, or the 
child that fails to make his grades. For the sake of argument let us 
assume that the yearly cost of keeping a child in school is $20.00, which 
is a very conservative estimate. Then, if a school have fifty pupils 
that fail to pass, the economic loss to the state is fifty times twenty, 
or $1000. The* reason a child fails to m_ake his grades can generally 
be attributed to one of three things — physical defects, incorrigibility 
of the child; or lack of co-operation of parents. 

By way oi digression, T will here state that Oi. H. H. Cloudman, 
a mar. of vide eypericnce in school hygiene, and fcr the past twelve 
years school physician and medical inspector of the Oklahoma City 
Schools, tells me that his experience has proved to his satisfaction that 
a large per cent of the backwardness of pupils is due to lack of am- 
bition and co-operation on the part of the parents. "Particularly is this 
of colored schools" said Dr. Cloudman. 

What a wonderful field is here open to the true teacher for real 
humanitarian service in the stimulation of ambition on the part of 
parents, and the bringing about of their co-operation. 

It is readily seen from the foregoing that every child who fails 
to make his grades and pass is an economic loss to the taxpayers of 
the state, p drain on the nervous vitalitj^ of th^ teacher, and a stumbl- 
ing block to other children. Whenever the strength of a teacher is 
overtaxed nervousness and irritability creep in with the result that the 
morale of the school is lowered, the efficiency of the teacher decreased 
and both teacher and pupil lose in physical vitality and mental alert- 
ness. Health supervisions of schools would lesson the possibility of 
such evils by tracing the cause of failure to make good, to the right 
source. 

CHILDREN SHOULD HAVE AS CAREFUL ATTENTION PHYSI- 
CALLY AS MENTALLY. 

To the subject of medical inspection of schools I have given much 
careful thought. I have discussed it with men of experience; with 
men who have had an opportunity to observe the value and usefulness 
of a similar method of inspection and checking in the United States 
Army. And I have reached the conclusion that every school child 
should have as careful attention physically as it does mentally. Med- 
ical supervision of schools would provide a means whereby many de- 
fects which should receive early attention would be recognized and 
corrected. 

My investigations have further convinced me that it would ^e 
conductive to progress, make for the protection of the commonwealth, 
increase the productiveness and add to the well-being of the individ- 
ual, and, greatly promote the general public health to have some form 
of compulsory health supervision in every school in Oklahoma. 

HOW MEDICAL INSPECTION MIGHT BE BROUGHT ABOUT 

This might be brought about in different ways. By way of sug- 
gestion, we might have created by legislative Act a Burea of Medical 



Inspection of Schools, this Bureau to function independently or under 
the supervision of the State Health Department; then select a man of 
experience, enthusiasm and initiative to take charge of such Bureau, 
a man who would throw himself heart and soul into the work. The 

duties of the Chief Physican of this Bureau to include outlining the 
work to county inspectors or school physicians and installation of 
checking systems, etc. 

Experience is emphasized as being one of the cheif requirement 
of the physician in charge of the Bureau of Medical Inspection of 
Schools, for the reason that the conduct of medical inspection is swch 
a technical matter and is so different from the work done by a prac- 
tising physician as to demand special training and experience. 

It occurs to me that medical inspection of schools might also be 
very effectively handled in the small towns and rural schools by 
combining the duties of the County Health Officers and those of 
School physician. In other words, the County Superintendent of 
Health to have supervision of medical inspection of schools in the 
small towns and rural sections. 

OTHER REASONS FOR HEALTH SUPERVISIONS OF SCHOOLS 

I think it will make for the protection of the community and 
furnish conditions under which boys and girls can develop strong, 
vigorous bodies. 

Twenty years spent in the practice of medicine in small towns 
and rural communities has convinced me that Oklahoma is being de- 
prived of intelligent, law abiding and productive citizens by reason of 
the lack of proper medical attention to our boys and girls during their 
early school days. 

AN ILLUSTRATION IN POINT 

A child apparently normal is placed in a school where physical 
defects are disregarded and probably unrecognized. This child seems 
to get along alright in its primer which is in large print, and so far 
there is no reason for parent or teacher to suspect a physical defect. 
When it reaches about the fifth grade where it is compelled to do a 
great deal reading from books in much smaller print, the child begins 
to devlop syn^iptons of defective eyesight. He has head aches, is un- 
able to see distinctly, has eye strain, it is hard for him to concentrate. 
He cannot see the blackboard and charts. Printed books in smaller 
type, the size he is now compelled to use, can only be seen with effort 
— everything is blurred, and failure follows all his efforts to study. 
Neither he nor the teacher knows what is the matter, but it is soon 
very evident that he cannot keep the pace with his companions ,and 
the child becomes discouraged and falls behind in the race. 

And in no better plight is the child suffering from enlarged ton- 
sils and adenoids, which prevent his breathing through the nose and 
compel him to keep his mouth open in order to breathe. This retards 
the development of the lungs, makes him more susceptible to disease by 
reason of germs entering his body by way of his mouth, also because 
of kwered vitality caused by absorption of poisen into the system from 
the diseased tonsiles. Perhaps one of his troubles is partial deaf- 
ness. He is soon considered stupid, and this impression is strength- 
ened by his poor progress in school. As he grows older his progress 
in his studies is slower. Through no fault of his own such a child is 
doomed to failure. He neglects his studies, is thoroughly discourag- 
ed and the conviction is borne in upon him that he is inferior in intellect 
to his companions. He begins to hate his school, leaves long before 
he completes his course, and is well started on the road to shiftless, 
inefficient and despondent life. 

13 



Teacher, if you only knew the terrible heartache and discourag- 
ment of these little unfortunates, many of whom come from homes al- 
most devoid of sjanpathy, where a kind word and a loving caress i& 
practically unknown, you would speak a kind, sympathetic word, give 
a pat of encouragement, and have infinitely more patience, where you 
now sometimes find fault. 

By the correction of such defects in early life such unfortunate 
children would have an equal chance with healthy, normal boys and 
girls to grow up into useful, intelligent citizens. 

WOULD AID IN WORK OF STATE HEALTH DEPARTMENT 

Medical inspection of Schools would also be of material aid in 
the work of this Department, in that it would lessen the spread of 
infectious and contagious disease, it having been conclusively proved 
that schools having no form of medical inspection are the principal 
means of disseminating disease through the community. It would also' 
aid in carrjdng out of the plan of education along health lines con- 
ducted by the State Health Deuartment. 

il trust I shall live to see the day when every boy and girl 
in Oklahoma will have the advantages and benefits to be derived from 
health inspection of schools, a school physician and a public health 
nurse. 

KEEPING RECORDS IN MEDICAL INSPECTION 

In any system of medical inspection which includes physical ex- 
aminations the matter of keeping records is of the greatest importance. 
A good system of individual records is imperative. General informa- 
tion is not sufficent. There must be a complete individual record 
for each child. This record card must have on it spaces for recording 
results of subsequent examinations as well as the initial one. If thif- 
work is to be of the highest practical value, there must be the closest 
connection between records of the physical examination and the class- 
room work. It would result in little good to have a record card on 
file in the principal's office, or in the office of the Department of 
Healtii to the effect that a pupil had defective hearing in the left ear, 
if the teacher knew nothing of this fact and still kept such pupil seated 
in the farthest corner of the room. It is also very obvious that if the 
records do not follow the child from room to room, and from school 
to school, much of the work is soon rendered valueless. 

RECORD CARDS, TRANSFER BLANKS, ETC. 

Through the courtesy of Dr. H. H. Cloudman blanks, including 
inspection record, scholastic progress, transfers, health certificate of 
teacher and notice to parents of physical examination, used in the 
schools of Oklahoma City, are reproduced here. These are full, simple 
and comprehensive, and seem to furnish all information necessary in* 
the transfer of pupils and for keeping a complete check at all times. 

THE SCHOOL NURSE 

A good public health nurse constitutes the best investment atny 
community can make. If no other health work has been undertaken 
a school nurse will start the good work by organizing a demonstration^ 
to awaken the community to its needs. 

14 



Original Enfry 


TRANSFERS 

Grade 

School 


Date 


Transferred to 
Transferred to 


Prin 

School 

Prin „ 

School 


"- - 




Prin 

School _ 

Prin 

School 

Prin _ 

School 

Prin 

School 




Transferred to 


- - 


Transferred to 
Transferred to 
Transferred to 


■ ■■ """* " 




Prin 

School 

Prin. 




Transferred to 












OKLAHOMA CITY PUBLIC SCHOOLS 

Date ;.19 

Name Age 

Height Weight 

Residence 

Are both parents living? 

Brothers in home ? 

Sister in home ? 

Mark (y) the following diseases you have had: 
Mumps Typoid Fever Asthma 

Measles Diphtheria Cough 

Whooping Cough Pneumonia Catarrh 

Chicken Pox Skin Disease Headaches. 

Small Pox Scarlet Fever 

Has been troubled with: 

Eyes Ears _ j Nose Throat 

Has these been treated? ,.... 

Vaccinated Successful 

Yes Yes 

No No 

Has any member of family h«d Tuberculosis? - 

Signed _ > 

Parent or Guardian. 
(PARENTS FILL THIS SIDE ONLY) 



Teeth. 



15 



INSPECTION RECORD 



Eyes Treated. 

Ears - Treated. 

Nose - Treated. 

Throat Treated. 

Teeth Treated. 

Cardiac Disease 

Pulmonary _ 

Skin Disease 

Nervous Disease 

Anaemia 

Orthopedic Defects 

Mentality 

Conduct 

Effort 

Proficiency '. _ 

Co-operation 

Treatment Needed 



_ M. D. 

Medical Inspector. 



SCHOLASTIC PROGRESS 

Entry f Failure Date Promotion Date 

IB _ 

lA 

2B '.. 

2A , 

3B 

3A 

4B 

4A 

5B 

5A 

6P „ 

6A , 

7B 

7A 

8B : 

8A 

HIGH SCHOOL „ „ 

fReason for Failure 



(Teacher sign cross entry) 
16 



OKLAHOMA CITY 

BOARD of 

EDUCATION 



^taitf) Certificate 

of : 

Assigned to - School 

Date 



Art. IV, Rule 5. 

All teachers and employees of the Board of Education shall, be- 
fore signing a contract, present to the Medical Inspector an acceptable 
certificate of good health or submit to an examination. All certifi- 
cate j shall be presented on a form furnished by the Medical Inspector. 



Name „ ; ..— 

Bom - Where ~ 

Residence „ ; - 

Has any member of your family had tuberculosis? 

cancer ? mental or nervous disease ? 

Have you ever lived with any one afflicted with tuberculosis? — 

Check diseases you have had: 
Mumps Typhoid Fever 
Measles Malaria 
Chicken Pox Asthma 
Whooping Cough Catarrh 
Diptheria Pleursy 
Small Pox Appendicitis 
Headaches Tuberculosis 
Constipation 
Have you ever been advised to change climate? _ _ 

Why? ".. 

Have you had any surgical operations? _ When? 

Result 

Has there been any trouble with Eyes? - JEars? _ 

Nose? - Throat? Teeth? 

Have these been treated? 

Vaccinations : 

Small Pox Date Successful? 

Typhoid Date 

Do you carry life insurance? _ 

Date of last policy - 

Signed - 

17 



EXAMINATION 

Personal appearance - 

Physique 

Temperature „...„ _ 

Pulse, rate _ _...„ Character _ 

Heart: 

Si-ze Character of beat _ 

Murmers 

Lungs : 

Inspection _ _ Percussion - 

Abdomen: 

Local tenderness _...„ 

Cause ....- 

Nervous sytem _ _ _ „ 

Condition of Eyes _ Ears > Nose 

Throat Teeth - 

Are you the family physician of the applicant? - 

Would you as a parent object to having this applicant in charge 

of the room in which a child of yours is a pupil ? _ „ _ 

„ - _.- .,.-.- M. D. 

Examiner. 

Date „ ..._ 



Room. 

Oklahoma City, Okla., _.... 19..„.- 

Your child....„ _ Jias heem 

inspected by me and I find JJ^ presenting symptons indicating 



I recommed that special treatment be given. 

Please report your intentions on this card and return to Principal. 

Remarks: ...._ .:.. ....- — 

H. H. Cioudman. M. D. 
209 City Hall Medical Inspector. 



Health Rules for Children 

1. Begin the day by washing your face and hands, cleaning your 
finger nails, brushing your teeth, and drinking a glass of pure water. 

2. If possible eat some cereal for breakfast. East bread and but- 
ter at every meal. 

3. Eat three regular meals a day, some vegetable every day, and 
chew your food well. 

4. Milk is your best food. Drink plenty of it. 

5. Buy more fi-uit and less candy. Always wash fruit well be 
fore eating. 

6. Do not eat with a knife, fork or spoon that has been used by 
another person, nor use any drinking cup except your own. 

7. Coffee and tea are injurious, and you should never get into 
the habit of drinking them. 

8. Disease germs grow best in filth; so keep your mouth and 
body clean. Take frequent baths. Never eat with dirty hands. 

9. Habits are easily formed. Cultivate the "tooth brush habit." 

10. The happier you are the healthier you will be. Cultivate a 
happy disposition. 

18 



Diseases of Children 

Under this heading may be classed all maladies which attack 
•children so universally that few persons attain majority without hav- 
ing undergone one or more of them. Among them are whooping 
"COUgh, mumps, measles, scarlet fever, diphtheria, chicken pox, and 
until recent years smallpox might rightfully Oe included in this list. 
Every one of these is a germ disease, highly contagious and most of 
them capable of causing death. 

But dangerous as these diseases are of themselves, they are many 
times more deadly in their after effects. Lucky, indeed, is the child 
who runs the gauntlet of the 'Diseases of Children* and escapes with- 
out a weakened heart, chronic bronchitis, tuberculosis, partial deaf- 
ness, weak eyes, or some other defect that will hamper him through 
life, and perhaps cut short his life by many years. 

These plagues of the innocent could be robbed of many of their 
terrors if proper care were taken of the child during convalescence. 
That is the point of danger. Believing that the danger is past re- 
strictions are relaxed, the child is allowed to leave the room too soon 
and complications follow. The light inflames the eyes and the child 
is blinded or has weak eyes for life. The body is chilled, and there is 
bronchitis, pneumonia, or even tuberculosis. Sometimes it is the kid- 
neys that receive the strain and Bright's disease is the consequence. 



Measles 



Measles is known in every civilized country and is thought to 
'have been brought to America by the early settlers. It is dangerous 
from the beginning, even before the eruption can be seen and for about 
a week thereafter. The virus or poison lives for a little more than a 
^y outside of the body and will not produce the disease after twenty- 
four hours. It is dangerous for a child with the measles to cough in 
io the face of other children who have not had it, or to touch them 
with unwashed hands or to give them any article that is has handled 
or that has passed its lips. 

Measles is a disease of close association; hence its increase dur- 
ing the colder months. 

CAUSE — It is thought by many that measles is a germ disease 
•and that there are chronic carriers, but this has not been proved. It 
IS not known what the cause of measles is. A great many scientists 
Tiave described the germs which they believe the causual agent, but 
these have not been positively proven as the cause of measles. We do 
Taiow, however, that the infection of measles is found in the secre- 
tions from the nose and throat during the first stages of the disease. 

AGE — Measles may occur at any age, even in old age. It is most 
fatal from the second to the fifth year, and most common from the 
fifth to the eighth year. The longer one can put off having the 
measles the better, because the younger the child is when it has the 
measles the more likely it is to die, and the more likely it is to suffer 
severe effects from it, even if it does not die. 

INCUBATION — If a child is exposed to measles and does not take 
the disease in fourteen days, it will escape an attack at the time. 

Measles is contracted by direct exposure to a case, and always 
in its early course, just before or after the eruption appears. This 
-disease is not likely to be contracted from clothing or hankerchiefs 
unless these contain fresh mucus from a patient with the measles. 
The disease is not infectious longer than a week or ten days. 

19 



SYMPTONS — Measles usually begins with a moderately high fever 
generally the younger the child the higher the f.?ver; cold in the head, 
a dry, hoarse, barking cough; red, watery eys that shun the light; 
i-unning nose; sore throat; an einiption behind the ears and on thic 
forehead at the roots of the hair. These are the early symptons. In 
a few days rash appears behind the ears, on the forehead near the 
hair and on the neck and chest. On the third or fourth day rash ap- 
pears on the arms and legs and spreads -o the palms of the hands 
and soles of the feet, and by this time the rash on the face is beginning 
to fade. 

COMPLICATIONS — In severe cases bronchitis and pneumonia 
are frequent complications. The late complications after the child re- 
covei^ are disease of the teeth. If you can prevent children contract- 
ing measles until after they are seven years old you may help preserve 
their teeth. Both measles and whooping cough frequently attack the 
teeth. 

EAR — The most serious complication in measles is found in the 
ear. Why Ifie vii-us of this disease attacks the ear is not known, but 
that it does so is sho^^^l by the large number of inflamed ears in meas- 
les and consequent deafness in later life. Earache in measles is al- 
ways a dangerous complication; but ear complications in this disease 
are not always attended by pain. The child will sometimes have its 
ear drum swollen and full of pus and the pus v/ill break through and 
damage or destroy the ear diTim without the slightest evidence of 
pain. To avoid this complication have your doctor make daily examin- 
ations of the ear. Unless the ears are inspected every day the first 
sign of danger may be a running ear. Remember that children do 
not always become deaf or hard of hearing after measles in child- 
hood, but often, twenty or thirty years later, and because ®f deafness 
they are deprived of many advancements and financial opportunities, 
and many of the delights of music and conversation. 

TREATMENT— A child with the measles should be put to bed and 
kept there as long as it has any fever or cough. The room should be 
airy but darkened, because children wdth measles are very sensitive 
to light. The bed clothes should be light and comfortable, as the pa- 
tient is likely to get too warm and kick off the covers and take cold. 
A chilling in this way may predispose to pneumonia. Food should be 
light and consist chiefly of nutricious broths, pasteurized milk and 
soft boiled eggs, and such food as the doctor recommends. Iced lem- 
onade is very cooling to the inflamed throat. The eyes should be kept 
clean, and should the fever get high, the comfort of the patient may 
be increased by sponging with tepid water and alcohol. 

The teeth should be brushed night and morning and after taking 
food, and the mouth well rinsed out with salt v^ater. 

Don't use patent medicines. Don't take any chances, but call your 
family physician upon the appearance of the first symptons and thus 
reduce the possibilities of complications. If you know a child has 
been exnosed to measles keep it under obsei-^^ation until about the 
eighth day and then call the doctor. 



Whooping Cough 

Whooping cough is a serious disease in its immediate and remote 
effects. The name of this disease is descriptive of the peculiar cough 
associated with it. An attack of the disease in a healthy child of four 
years or older rarely proves fatal; but in a delicate child, especially 
with latent tuberculosis, and also in the aged, whooping cough is al- 
ways to be dreaded. 

20 



CAUSE — Whooping cough is caused by a germ which is present 
in the spittle thrown out when the patient coughs or vomits. The 
germs are present at all stages of the disease but most abundant at 
the beginning of the whoop, and for that reason the disease is most 
dangerous at that time. 

AGE — No age is exempt, but this disease occurs more frequently 
than any other infectious disease during the iirst six months of life. 
The largest number of cases and the greai:est number of deaths 
occur in the first year of life. 

INCUBATION — The exact period of incubacion is not known. 
Observations seem to show that it varies from two days to two ,veeks. 
It seems to be pretty well proved that whooping cough \s transferred 
from one person to another by fairly close contact only, an-l that the 
sputum is the agency by which the germs leave the body of the pa- 
tient. During violent coughing the sputum ih thrown a consideraole 
(["stance in the form of a fine spray and in this vvav, and also by means 
oi handkerchiefs, bedclothes, etc., recently sprinki.el with spatum, that 
the geiTns are carried. This disease is believed by some to be trans- 
mitted three or four weeks after the last whoop is heard. 

SYMPTONS— The first symptons are those of an ordinary cold 
in the head and thorax; iiinning of ':he n r^c, .^Ji^ht fevei, ar.J a c'ry, 
jeiky cough, which has a tendency tc- ' e spasmod'c. In mil i attpicks 
the child may cough only a few times .' I iv, h:,c in )thei cases the 
seizures may occur quite often. If the child is kept quiet the par- 
ax y:sms occur much less frequently. 

In severe cases there may be bleeding of the nose or into the 
whites of the eyes and blood may come from the ears or the mouth. 
There is likely to be loss of appetite, and because of vomiting there 
is a loss of flesh arid consequent weakness, m the early stages the 
eyelids are red and swollen, and the face may have a puffed appear- 
ance, particularly during the cough. 

COMPLICATIONS— Pneumonia and bronchitis are the chief com- 
plications, but these usually occur in cases under five years of age. 
DiaiTheal disease is a frequent complication during the sunmier 
months. 

PREVENTION— To prevent getting this disease keep away from 
it. Everything that has come in contact with a patient having 
whooping cough should be sterilized before it is allowed to come in con 

tact with others. 

TREATMENT — Whooping cough is a dangerous disease, and no 
child should be allowed to go through an attack without inteHigent 
care and attention. Upon appearance of the first symptoms send for 
the doctor and keep the child' under observation. Fresh air and plenty 
of it is one of the best remedies. 

Clean the teeth after meals, morning and night, and rinse out the 
mouth well; also rinse the mouth after every attack of coughing. It 
is believed that this disease causes decay of the teeth especially when 
children have it before they are seven years old. 

The records of the Vital Statistics Bureau of the State Depart- 
ment of Health show a marked decrease in deaths from both measles 
and whooping cough in 1919. There were 37 deaths reported ft'om 
measles and 81 from whoping cough in Oklahoma against 255 from 
measles and 259 from whooping cough in 1918. 

21 



Diphtheria 



Diphtheria is one of the most dreaded diseases of childhood. Due 
to modern discoveries, however, there are few diseases about which we 
know so much. Its prevention and_ control are feasible, provided there 
is intelligent co-operation of the sanitary authorities, medical profes- 
sion, parents and teachers, and the general public. 

Whether or not Diphtheria is one of the most dangerous or one 
«f the least dangerous of diseases depends up-)-! the way it is treated. 
It is one of the least dangerous when treated v-ith anti- toxin; and -3 
one of the most dang-erous when the anti-toxin treatment is insuffi- 
dent, delayed or not given. Before the .liscoverv of anti-toxin one 
®ut of every three children who had diphtheria died. 

Ninety-eieht out of every hundred now recover if anti-toxin is 
used on the first or second day. The sooner this .disease is attended 
to the more certain is a cure. A delay of a few hours may prove 
fatal. 

CAUSE — Diphtheria is caused by the growth, usually in the nose, 
throat or windpipe, of a germ known as the "Klebs-Loeffler bacillus/* 

Thrs germ was discovered by Klebs and fir?t studied by Loeffler, 
hence its name. The form of this germ is quite distinctive and trained 
observers hc*ve very little difficulty in differentiating between it and 
other germs found in the throat. This germ is always found in persons 
laving diphtheria at the spot where the disease process is going on. 

Milk is r.nother carrier of diphthria, and as a result we have many 
outbreaks of this disease caused by infected milk. The germs get into 
the Jmilk at the farm or diary by reason of the presence of a case of 
diphtheria, or because some member of the farm or diary force was a 
diphtheria bacillus "carrier." The diphtheria germ has been grown in 
a number of instances from milk causing epidemics, which proves the 
connectioi^ between milk and the outbreak. 

Since we have learned so much about diphtheria we know that the 
disease is kept alive and transmitted by the presence among us of 
"carriers." Carriers are persons who harbor the germs in their 
throats, in adenoids or tonsils, in their noses or in decayed teeth, and 
who are apparently well and have no symptoms of the disease. Such 
persons are immune by reason of having sufficient anti-toxin in their 
bodies to protect them against the disease. 

AGE — Diphtheria victims are chiefly children under five years of 
age. However, at no age is one entirely immune. It is estimated that 
about 75 out of every 100 adults will not take diphtheria because they 
have enogh natural anti-toxin in their bodies to protect them. There 
is no difference in the sexes as to susceptibility to the disease. 

SYMPTONS — The patient becomes sick in three to ten days after 
exposure to this disease. There are three types of diphtheria which 
merge into each other so that we cannot always separate them. 

SIMPLE LOCAL DIPHTHERIA— This type begins with slight 
fever. Often there is a feeling of chilliness and the back and limbs 
may ache. There is a slie-ht sore throat and the patient complains of 
pain upon swallowing, which is caused by swelling of the tonsils. 
Upon examination of the throat a grayish membrane is found forming 
apon the tonsils soft palate and vicinity. The light nature of these 
symptons ima^' be due either to high natural resistance to the disease 
or to the fact that but little of the poison was adsorbed. 

DIPHTHERIA AND GENERAL ILLNESS— In this second type 
of infection the fever is high from the beginning. The patient is 
asually restless and delirious, with a rapid pulse. All throat symp- 
^ms are much more pronounced and the membrane has a tendency 



to spread up into the nose and down into the windpipe. The surface 
of the body become cool and clammy, and the lips and face are purple. 
Death may follow from suffocation or heart failure. 

SEPTIC FORM OF DIPHTHERIA 

In this form we have from the beginning symptoms of a severe 
illness. The membrane spreads rapidly and has a tendency to cause 
the death of the underlying tissues. Large sloughs form, leaving 
deep ulcers behind. The odor of the breath becomes very offensive. 

COMPLICATIONS — ^Paralysis of one or oiore groups of muscles 
is a common complication of this disease. The tmuscles usuallv af- 
fected are those of the palate, the throat, and the eye. Paralysis of 
the nerves of the heart may take place, causing sudden death even a 
considerable time after local symptons have disappeared and the pa- 
tient thought to be out of danp-er. 

PREVENTION — Every person susceptible to diphtheria should be 
immunized against it. As to whether a person can contract this dis- 
ease may be determined by a very simple test known as the "Schick 
Test." This test consists in injecting a few drops of prepared diph- 
theria anti-toxin into the skin. If a red spot does not appear at the 
point of injection within two cr three days, it shows that the percon 
cannot catch diphtheria. Those whom this test shows to be suscepti- 
ble to diphtheria should take the protective treatment which consists 
of three small injections of anti-toxin, a weeK apart. 

All precautions taken in other infectious and contagious diseases 
will be helpful in preventing the spread of diphtheria. 



Scarlet Fever 



Scarlet Fever is an acute infectious and ontagious disease. In- 
fection exists from the earliest symptons and cc-rlinues long after con- 
valescense has been established. Epideimics iv3 more common in this 
country in the fall and winter, but malignant cases are not unknown 
even in mid- summer. 

CAUSE — The micro-organism of scarlet fever has not been isolat- 
ed. 

AGE — Children under ten years of age are most susceptible-, 
ninety per cent of the cases occur in children under ten. After the 
tenth year resistance to the disease increases. The reason why infants 
at the breast are less likely to contract the disease is attributed to the 
dimished chances of infection entering the mouth. One attack usually 
protect one from subsequent attacks. 

INCUBATION— From a few hours to a week. Scarlet fever is 
not contagious durin-^ the period of incubation. It is most contagious 
during the period of eruption. This disease is readily communicable 
but less so than measles or smallDox. 

SYMPTONS — The onset is usually very sudden. In very young 
children the attack is preceded by convulsions. Vcraiiting is an early 
sympton. Sore throat with pain and difficulty in swallowing; full- 
ness and tenderness beneath the jaw. The tongue is at first heavily 
coated and red at the tip and edges. After a few days the coating 
disappears from the tongue and the papillae become a bright red and 
swollen. About the second day a scarlet red rash apnears on the neci 
and chest and rapidly spreads over the entire bcdy. 

23 



COMPLICATIONS— The most common is nephritis. Nephritis 

may be the immediate cause of death in scarlet fever, or it may be- 
come chronic. Many cases, however, result in complete recovery. 
There are many other complications, among which may be mentioned 
inflamation of the middle ear, and a peculiar inflamation of the joints 
resembling rheumatism. 

TREATMENT — The first thing to do in a case of scarlet fever is 
to isolate the patient and remove all healthv children and adults. All 
articles usedjn the sick room should be thoroaghly disinfected befor:; 
bemp- removed. To prevent dissemination of scales cocoa-butter or 
cold cream should be applied to the body of the patient at least once a 
day. The p^^tient should not be allowed to l^ave his bed for a week 
after the fever has subsided. Tepid sponging during the period of 
fever is very grateful and adds to the comfort of the patient. Follow 
the directions of your doctor closely. 



Chicken Pox 



Chickenpox is one of the minor communicable diseases, in that 
mortality is practically nil and complications rare. This disease is 
recognized as comparatively harmless, but because small pox is so 
frequently mistaken for it in its early stages that it is always advis- 
able to summon a physician upon the appearance of the first symp- 
tons. 

This disease occurs sporadically and epidemically. It is essen- 
tially a child's disease, but adults are not exempt. One attack usually 
protects from another. 

INCUBATION— From fourteen to sixteen days. 

SYMPTONS— In most cases there is a slight fever with chilli- 
ness. Within the first twentv-four hours an eruption appears. 

TREATMENT— No special treatment is required. The child 
should be separated from others until the crusts have disappeared. 
Itching may be allayed by the application of carbolized vaseline. 



Colds 



One of the most prevalent of cUseases is the common cold. Every 
one is so familiar with a cold that a description would be superflous. 
Colds are infectious. We used to believe that sitting in a draft would 
produce a cold. We now know that a cold is caused by a germ re- 
ceived from another person. These germs leave the body through 
the secretions of the mouth and nose and enter the body through the 
same route. 

Many cases of pneumonia begin as common colds. And while colds 
do not produce tuberculosis, yet what is considered a cold may in 
reality be the first symptoms of that disease. 

Colds occur in epidemics and are distinctly contagious. Schools 
and industries are crippled by such epidemics and complications and 
serious disorders following the disease add to the great economic loss 
produced in this way. 

To prevent a cold avoid hot, stuffy, unventilated rooms. Take 
exercise regularly in the open air; plenty of sleep; keep the body, 
mouth and nose clean; avoid exposure to sudden changes of tempera- 
ture and the chilling of the body either by wet or cold. Keep bodily 

24 



resistance at the top notch. A cold lowers the vitality and resisting 
power, thus making a person more susceptible and less able to with- 
stand the onslaught of other diseases. Colds are serious and should 
be treated as such. Save time and inconvenience by consulting a 
physician upon the first appearance of a cold. 

All articles used by the patient should be sterilized. Kissing, and 
use of common drinking cups and towels should be prohibited, it being 
borne in mind constantly that colds are infectious and readily spread 
from one person to another. 



Health Quotations 

The first wealth is health. — Lytton. 

Why should thou die before thy time?— Eccl. 7:17. 

The tongue of the wise is health. — Prov. XII :18. 

Gold that buys health can never be ill spent. — Jno. Webster. 

He who has health has hope, and he who iias hope has everj^hing. 
— Arabian Proverb. 

There is no kind of achievement equal to perfect health. — 
Theodore Roosevelt. 

Health is the essential factor in producti'/eness, prosperity and 
happiness — and hence in the advancement of civilization. — Sir Freder- 
ick Treves. 

The Public Health is the foundation upon which reposes the hap- 
piness of the pepole and the strength )£ ihe nation. The care of the 
public health is the first duty of a statesman. — ] /israeli. 

Our National health is our greatest asset. To prevent any poss- 
ible deterioration of the American stock should be a national ambi- 
tion. — ^Roosevelt. 

He who has not health has nothing. — Rosseau. 



Recommendations for Promoting Health and 

Efficiency in the Small Town and 

Rural Schools. 

A child today, a citizen tomorrow. To raise the standard of cur 
citizenship our efforts must largely be directed tow^ard the child. The 
most effective way to reach the ohild ic thr ^a.i^h the public schools. 
Therefore it follows that if we would raise the level of our citizenship 
we must raise the level of our public schools. 

r.EED OF mCrHF.U STANDARD 

Tiie ]jni:)erati\e need for a nigh )r standard, both from the stand- 
point Gi hea.th ?i d education, was brought home to us ^ery forcibly 
by the fact that s li:'rge per cent jf ur young manhood was not phys- 
ically acce.'.L":. e for service in the late war. Examinations farther 
showed that the exent of lUit '.racy was appalling many men whon 
drafted into service being unable to read and correctly construe orders, 
and that a still larger per cent had never gone beyond the third or 
fourth grades. 

That such regrettable conditions may no longer obtain in our pro- 
gressive state; that the child in the small town and rural sections 
may have an equal opportunity with the child in the city for at least 
eighth grade and high school training, I favor abolishing some of our 
state schools and applying the monej's now used for their maintenance 
toward the building of substantial, modern school buildings in the 
small towns and rural communities, furnished with modem eqiupment 
rand to the empIo^Tnent of better paid, more highly trained teachers. 

25 



While we are proud of our higher institutions of learning — and 
none more proud than myself — yet, such a smrJl number of our chil- 
dren will ever benefit by the advantages offered by such instituti-ons 
compared to the great number that must of stem necessity say fare- 
w^ell to school days when the eigth grade or, at most, when high 
school is finished. 



STATE FUNDS SHOULD BE APPLIED WHERE THEY WILL 
PROFIT LARGEST NUMBER 

That laws shall be framed for the promotion of the general wel- 
fare is one of the basic principles of our Federal Institution. (And 
justice and fair dealing demand that the public funds of a state shall 
be applied where they will bring the greatest profit and Imost good to 
the largest number. 



MODERN SCHOOL HOUSES FOR RURAL COMMUNITIES 

The time has arrived when, if we are wise and can read aright 
the signs of the times, we must look at facts and deal with conditions 
in a practical way. If our nation is to endure indefinitely as the 
brightest star in the galaxy of nations and continue to be singled out 
and looked upon by other peoples as a model, the old time sentiment 
and glamour clinging about the little, rustic schoolhouse on the hill 
must be dispelled and the country schoolhouse replaced, in this and 
other states, by a modern, well lighted, well heated, well ventilated 
consolidated school building. 

This modern schoolhouse must be builded and equinped with all 
due regard to the health and comfort of the children, whose parentage 
has ever been our country's most loyal and dependable citizens and 
the first to spring to the defense of our nation's honor. 



SIZE AND ARRANGEMENT OF SEATS AND DESKS 

The seats in this modem building to be arranged to the best 
possible advantage with regard to the light that there may be no strain 
on the youthful eyes. Every child should be given a seat which will 
permit its feet to rest comfortably on the floor; otherwise, the child 
will swing its feet all day which depletes energy and brings about 
the establishment of nervous habits. 

The desk should not be too high nor too low; as in either case 
it is a strain on the spine and throws the little body out of correct 
posture. "As the twig is bent, so the tree is inclined." 



DOMESTIC SCIENCE DEPARTMENT IN EVERY SCHOOL 

Because poor cooking and unbalanced rations are responsible for 
numberless victims of stomach trouble, gastritis, and that great curse 
of the American people— CONSTIPATION, I would like to stress the 
importance of a fully equipped dofmestic science department in every 
school. It is also important that a course in this Department be made 
compulsory for girls, as in addition to teaching them how to combine 
and properly prepare foods, it will also engender thrift in our future 
housewives. 

It is essential every child should have warm nourishing food for 
its lunch, including a bowl of hot soup, hot mialted milk, etc. Such 
food could be prepared in the domestic science department at the min- 
imum cost. The average lunch usually eaten by the child in the 
country school too often consists of the leavings of an unwholesome 

16 



breakfast which would tax the digestive powers of a strong man en- 
gaged in manual labor. Then we wonder why some of our children 
are dull, slow of comprehension, unable to concentrate, and fall be- 
ii'nd in their classes. Unbalanced and fautly rations are now believed 
by scientific men to create conditions that bring about pellagara. 




SCHOOL HYGIENE 

The teacher or school physician should notice closely the light- 
ing, heating and ventilation of the school room; also location of the 
source of the water supply with reference to possible pollution. Should 
pollution of the water supply be suspected, a sample of the water 
should be sent to the State Health Laboratory, Second & Stiles Sts., 
Oklahoma City, for examination and analysis. The teacher should 
also look closely to the cleanliness of her room, and the adfmission of 
sunlight, when possible, is desirable. 



UNWASHED HANDS SPREAD DISEASE 

If there are no facilities furnished for the children to wash their 
hands before eating their noon lunch, the teacher should insist on such 
facilities being installed and should make an iron-clad rule, requiring 
every child to thoroghly wash its hands with soap before eating its 
lunch. Each child should use his own cake of soap, a sanitary towel 
and a sanitary drinking cup. It is now recognized the comon towel, 
-common drinking cup, and the handling of food with unwashed hands 
.are prolific sources in the spread of disease. 



ATTENTION TO TOILETS 

The toilets should receive attention. The floors should be clean 
and dry, and the bowls properly emptied. If outside closets are used, 
large supply of earth or the generous use of quick lime will aid in 
keeping the place in sanitary condition. A few directions regarding 
•the cleanliness of the room should be posted in the toilets or closets. 



SCHOOL FURNITURE 

All pupils should be seated with reference to comfort. Each child 
should have a seat of such height that the feet will rest easily on the 
jfloor. The desk should not be high enough to touch the knees, and 
should be low enough for the arms to rest comfortably without much 
raising of the elbows; but not low enough that the student must bend 
down to write. 

The seat should be near enough that the scholar mav reach the 
^esk to write on it without leaning forward but slightly so that the 
jw^port of the back rest will not fee entirely lost. The seat should 
not be so close as to press against the abdomen nor near enough to 
interfere with easy rising fronn the seat. This means that the seat 
must not project under the desk more than an inch at most. 

The seat should have a back rest that will support the small of the 
hack properly without the student having to lean back excessively. 
Whether or not the rest of the back is supported is of small conse- 
quence; support of the back up to the shoulder blades is likely to do as 
much harm as good. 

The floor of the school room should never be dry when swept, but 
should first be covered with some kind of a sweeping compound or 
:sprinkled with cinide oil. 

The use of black-boards in all up to date schools have been dis- 



continued. Blackboards should go into the discard everywhere. The 
inhalation of chalk dust by children bring about catarrhal conditions 
of the nose and throat, and other disorders of the respiratory glands 
and lungs. 



VISION AND HEARING TESTS 

Under the provisions of the Massachusetts statute each teacher 
is required to examine her pupils at least once a year for the purpose 
of testing their sight and hearing and making a report on the results 
found. Connecticut has ^, similar law. 

There is some difference of opinion among authorities on taedical 
supervision of schools as to whether or not the room teacher is compet- 
ent to detect signs of contagious diseases among her children. There is 
much less doubt expressed as to the ability of the teachers, especially 
ii she be given a little careful training, to successfully examine her 
pupils to detect the presence of eye trouble, defective hearing, and the 
more easily detected nose and throat defects. 

The mandatory provisions in the Massachusetts statute that tests 
for sight and hearing be conducted by the teachers have caused some 
surprise and criticism. However, we learn that such provisions were 
inserted upon the recommendation of specialists who deemed that 
such tests were wholly within the capacity of the teacher, and who 
were also of the opinion that the children would be subjected to less 
nervous strain than if tested by a stranger and therefore exhibit 
themselves in a more natural way. 

It is the intention of the Massaschusetts law that scientific ex- 
amination by specialists be made in cases where defects are revealed 
by the teacher's test. 

The equipment of every school should contain test charts, astig- 
matic charts and the multiple rod. And I am in favor of a law similar 
to that of Massachusetts and Connecticutt for sight and hearing tests 
to be made by teachers, and where such tests reveal defects that a 
scientific examination be made by a specialist. 



TO TEST THE EYESIGHT 

Hang the test chart (Snellen...s being perhaps the best and most 
universally used) in a good clear light on a level with the head. Place 
the child twenty feet from the letters, one eye being covered by a 
card held firmly against the nose without pressing on the covered eye, 
and have him read aloud the smallest letter he can see on the card. 
Make a report of the result. Exaimine each eye separately. Test the 
right eye first by having the letters named in order from the top 
downward. For the left eye have the letters named from right to 
left to avoid repetition by m.emory. 

Children under seven years need not be examined. 

Children wearing glasses should be tested with their glasses prop- 
erly adjusted to their eyes. 

It is better to examine the children singly and separately. As- 
certain whether the child habitually suffers from inflamed lids or 
eyes, and whether after study it has weariness or pain in the eyes 
or head, or is suffering from squint (cross eyes). 

Do not expose the charts when not in use, as familiarity leads to 
memorizing the letters. 

If it is suspected that the answers are being made from memory, 
cut a hole about one and one-half inches in a narrow strip of card- 
board so as to allow only one or two letters to show through the hole, 
and by skipping around rapidly it is easy to prevent memorizing of the 
letters. 

28 



TO TEST THE HEARING 

All children should be examined to ascertain whether or not they 
have defective hearing. 

Children should be examined singly and privately. 

Find whether the child has frequent earaches; has pus or a foul 
odor proceeding from either ear, suffers from frequent colds in the 
head, is subject to a constant catarrhal discharge from the nose or 
throat, or is a mouth breather. 

Seat the child facing you near one end of a QUIET room with the 
windows closed and begin the test of the hearing at a MEAS- 
URED distance of 25 feet. The test is made by having the left ear 
tightly closed with the finger while you observe the ability of the 
child to repeat your MODERATE whispers of numbers between 21 
and 99 inclusive. Test the right ear by having the left ear tightly 
closed. Avoid a wall behind you to act as a sounding board. The 
figures should be pronounced with as nearly equal emphasis as pos- 
sible. The distance at which a child correctly repeats a series of three 
numbers gives his hearing distance for that ear. No further test is 
necessary if the child hears the numbers perfectly with each ear. If 
this test shows a slight defect of either ear, further tests may be 
made by observing how the child hears the tick of a watch, which 
should be heard normally at a distance of not less than three feet. 

The hearing distance is recorded by a fraction. The distance you 
are from the child representing the enumerator and the denominator 
is 25. Therefore if he repeats the numbers correctly at 25 feet his 
hearing is 25-25 or normal. If he only repeats the numbers correctly 
when you are 20 feet his hearing is 20-25 or 4-5 normal, etc. 



FREE TEXT BOOKS 

Oklahoma no doubt possesses the talent, and I therefore think 
the writing of textbooks should be done by citizens of this state. 
Further, I can see no good reason why text books, tablets and pen- 
cils should not be made by convict labor and furnished by the state. 
This would remove a handicap from many a child whose progress is 
retarded because his parents are too poor or too indifferent to supply 
the necessary books. 



To Keep Well 



Ventilate every room. 

Wear loose, porous clothing, suited to season, weather and oc- 
cupation. 

If you are an indoor worker, be sure to get recreation out of 
doors. 

Sleep in fresh air always;' in the open if you can. 

Hold a handkerchief before your mouth and nose when you 
cough or sneeze and insist that others do so, too. 

Always wash your hands with soap before eating. 

Do not overeat. This applies particularly to meat and eggs. 

Eat some hard and bulky food; some fmits. 

Eat slowly — chew thoroughly. 

Drink sufficient water daily. 

Evacuate thoroughly, regularly. 

Stand, sit and walk erect. 

Keep th>!; teeth, eums and tongue clean. 

Work, play, and rest in moderation. 

29 



Keep serene. Worry is the foe of health. Cultivate the com- 
panionship of your f ellowmen. 

Avoid self drugging. Beware of the plausible humbug of the 
patent medicine fakir. 

Consult your doctor once a year, and your dentist every six 
months. 



SUGGESTIONS TO TEACHERS AND SCHOOL PHYSICIANS 

WITH REFERENCE TO MEDICAL SUPERVISION. 

INFECTIOUS DISEASES 

DIPHTHERIA. A mild case of diphtheria, minus constitutional 
disturbances, is recognized as a responsible factor in causing the 
spread of this disease, and that in such cases there is frequently a 
profuse discharge from the nose. It is therefore important that cul- 
tures should be taken from the nose in every case where there is a 
persistent discharge, particularly if there is any excoriation about 
the nostrils. 

The throat should be examined at frequent intervals, depend- 
ing upon physical condition of the child. Thickness of the voice or 
hoarseness should cause an examination of the throat. 

A child v\^ith positive cultures should be excluded from school un- 
til two negative culture have been obtained, allowing about forty- 
eight hours to elapse between cultures. 

SCARLET FEVER. If a child complains of a headache, has 
a red, ugly throat, a sudden attack of vomiting and a rise in tem- 
perature that is unaccounted for, the child should be isolated at once. 
Any peeling of the skin, any breaks at the finger tips, or if a white 
line shows at the juncture of the nail when the pulp of the finger is 
pressed upon, the child should be excluded from school. 

A child who has had scarlet fever should not be allowed to re- 
turn to school until all discharge from the nose and ears has ceased 
and the process of peeling of the skin has been entirely completed. 

MEASLES. Shrinking from the light and a running from the 
nose should cause an examination of the mucous membrane of the 
mouth for minute white blisters, without inflamation around them, 
near the molar teeth. There may be only two or three of these blis- 
ters and they may escape detection if the patient is not examined in 
a good light. Such blisters are certain fore-runners of an attack of 
measles. 

No child should return to school after having the measles until 
desquamation is completed, and it has entirely recovered from the in- 
i;ercurrent bronchitis. 

MUMPS. Tenderness and swelling in the region behind tiie 
tingle of the jaw, known as the "parettd glands" is a suspicious 
symptom. Also a frequent symptom of mumps is an enlargement or 
swelling inside the mouth, opposite the second molar tooth. 

No child should be allowed to return to school until the disap- 
pearance of all swelling and tenderness in the region of the parotid 
gland. 

WHOOPING COUGH. Whooping cough is indicated by a per- 
sistent, spasmodic cough accompanied by vomiting, whether or not 
there is any whoop. An ulcer on the band connecting the lower sur- 
face of the tongue with the floor of the mouth is found in many cases 
of whooping cough of long standing, even if there has been no dis- 
ttinct whoop. 

As long as there is any cough a child should not return to school. 

30 



CHICKEN POX. A few black crusts scattered over the body are 
evidence of a case of chicken pox. The crusting seen in impetigo 
must be deferentiated from that of chicken pox. 

A child having chicken pox should be excluded from school until 
all crusts have disappeared from the body, particularly from the 
scalp, as the crusts remain longer on the head than elsewhere. 

THE EYES. 

The ordinary test for normal vision show many children to be 
without defective vision. But if these same children are noticed to 
have the following peculiarities their parents should be notified to 
have their eyes tested: 

1. Children who habitually hold the book too near the head 
(less than fourteen inches.) 

2. Children who frequently complain of headaches, especially in 
the afternoon during the latter portion of school hours. 

3. Children having one eye that deviates even temporarily from 
the normal position. 

The teacher should also remember that the following symptoms 
are sometimes indicative of eye trouble: 

1. Habitual scowling and wrinkling of the forehead when read- 
ing or writing. 

2. Twitching of the face. 

3. Inattention, and backwardness in book studies in children 
otherwise bright. 



THE EARS 

Parents should be notified to have the ears of children looked 
after when there is any running from the ears, or crusty patches 
about them. A child is also hard of hearing and the matter should 
be looked after when it sits with its mouth open, which gives it a 
sottiewhat dull expression. When a child hears questions imperfectly 
it is slow in its studies and often stupid in its answers. 



THE THROAT AND NOSE 

In all cases of acute illness the throat should be examined for 
the presence of the eruption of scarlet fever and measles and for the 
membrane of tonsilitis and diphtheria, and a culture taken in any 
suspected case of the latter. 

The presence of any discharge from the nose should be noted, 
and if it is thick and creamy, a culture should also be taken. In all 
cases of severe hoarseness, with difficult breathing diphtheria should 
be suspected. If the discharge is only from one nostril, a foreign 
body in the nose should be looked for. 

In cases of chronic nasal obstruction, as evidenced by mouth 
breathing, snoring, continual post-nasal catarrh or recurring ear 
trouble, the presence of an adenoid growth should be suspected, and 
the child referred for special examination and treatment. As a rule, 
digital examination for adenoids should be made only by the operat- 
ing surgeon. Obviously large tonsils, recurring tonsilitis and en- 
largement of the glands of the neck, suggests the advisability of re- 
ferring the child to the family physician as to the propriety of re- 
moving the tonsils. 

Recurring nosebleed should be referred for special treatment. 

In case of eczema about the nostrils, the cause "may be sought in 
head lice. 

In referring cases for treatment, school physicians, in addition 
to the diagnosis, should state the symptoms upon which the diagnosis 
is based, for the benefit of the family physician or specialist. 

31 



DISEASES OF THE SKIN 

SOABIES (ITCH). A contagious skin disease, due to an animal 
parasite which burrows in the skin, causing intense itching and 
scratching. This disease usually begins upon the hands and arms, 
spreading over the whole body, but does not affect the face and 
scalp. Between the fingers, on the front of the wrists, at the bend 
of the elbows and near the arm-pits are favorite locations for the 
disease; but in persons of cleanly habits the disease may not show at 
all upon the hands, and its real nature is determined only after a 
most thorough and careful examination. There is a great variation 
in the extent and severity of this disease, lack of personal care and 
cleanliness always favoring its development. Scratching soon brings 
out an infection of the skin with some of the pus producing germs, 
and the disease is then accompanied by impetigo, or a pus infection 
of the skin. 

During the last school year itch was very common and wide- 
spread, and I had many inquiries concerning it from different parts 
of the state. Mild cases are often mistaken for hives or eczema, and" 
the disease spreads in consequence. All children who are scratching 
or have an irritation upon the skin should be examined for scabies. 

All infected members of the family should be treated until cured, 
else the disease is passed back and forth from one to another. It is 
important that all underclothing, bedding, towels, etc., things that 
come in contact with the body be boiled when washed. 

All cases of scabies should be excluded from school until cured. 

PEDICULI CAPITIS (HEAD LICE). The irritation caused by 
vermin in the scalp leads to scratching, which in turn causes inflama- 
tion of the skin of the neck and scalp. The skin then easily becomes 
infected with some of the pus-producing gei-ms, and scabs and crusts 
are foi^med from the dried matter and blood. This condition may be 
accompanied by the swelling of the glands back of the ears and in 
the neck, which may be very painful and tender. 

Head lice are more easily detected bv looking for the eggs (7iits'», 
which are always stuck on the hair, and are not easily brushed off. 
The condition is best treated by killing the living TDarasites with 
cinide oil and then getting rid of the nits. With boys this is an easy 
matter — a close haircut is all that is needed; with girls, by using a 
fine-toothed comb wet in alcohol or vinegar, which dissolves the at- 
tachment of the eggs to the hair. All combs and brushes should be 
carefuUv cleansed. 

Children with head lice should be excluded from school until their 
Tieads are clean. 

RINGWORM — A vegetable parasitic disease of the skin and scalo 
which yields reaclily to treatment upon the skin, but upon the scalp it 
is extremely chronic. Ringworm of the skin usually appears on the 
face and hands — rarely upon the skin of the body — in varying sized 
circles. All ringed eruptions upon the skin ^^hould be examined for 
ringworm. 

^^^len this .disease attacks the scalp, the hairs fall or break off 
near the scalp, leaving bald spots. The scalp in these areas is usually 
dry and somewhat scaly, but may be swollen and crusted. The dis- 
ease spreads at the edge of the circles or rings, and new areas arise 
from scratching, etc. 

Another disease, somewhat like ringworm of the scalp is known as 
favius. In this disease quite abundant crusts of yellowish color are 
present where the process is active. The roots of the hair are killed 
so that the loss of the hair from this disease is permanent, a scar re- 
Tnaining when the condition is cured. 

Care must be taken to see that all combs and brushes are care- 

32 



fully cleansed and to prevent children from wearing each others' hats 
and caps, etc. 

Children with ringworm should not be allowed to attend school. 

IMPETIGO— This disease is charactized by large or small flat or 
elevated pustules or festers upon the skin. The condition is often sec- 
ondary to irratation to itching diseases of the skin (hives, lice, itch) 
and scratching starts up a pus infection. 

The disease most often appears upon the face, neck and hands, 
less often upon the body and scalp. The size of the spots vary and 
often run together, forming on the face large superficial sores, cover- 
ed with thick, dirty, yellowish or brownish ciiists. 

The disease is contagious, and often spread by towels and things 
handled. 

Children having impetigo should be excluded and not allowed to 
return to school until all sores are healed and the skin smooth. 



DIESASE OF THE BONES AND JOINTS 

Noticable lameness, whether sudden or continued, may indicate 
seroious joint trouble, or may be due to improper and ill fitting shoQS. 
Such cases, as well as curvature of the spine, as indicated by habitual 
faulty postures at the desk or in walking, should be referred for medi- 
cal examination. 

Curvature of the spine should be suspected when one shoulder 
is habitually raised or dropped, or when a child leans to the side, or 
shows persistent round shoulders. 

Complaints of persistent "growing pains" or ''reheumatism" may 
be the earliest signs of serious disease of the joints. 



GENERAL SYMPTONS OF DISEASE WHICH THE TEACHER 

SHOULD NOTICE, AND ON ACCOUNT OF WHICH THE 

CHILDREN SHOULD BE REFERRED TO THE 

' SCHOOL OR FAMILY PHYSICIAN. 

EMACIATION — This is a manifestation of many chronic dis- 
eases, and may point particularly to tuberculosis. 

PALLOR — Pallor usually indicates anemia. Pallor in young girls 
usually means chlorosis — a form of anemia peculiar to girls at aboui; 
the age of puberty. It is usually associated with shortness of breath; 
the condition may otherwise appear good. Pallor may also be a man- 
ifestation of diseases of the kidneys; this is almost invariably the case 
if it is associated with puffiness of the face. 

PUFFINESS OF THE FACE— This, especially if it is about the 
eyes, points to disease of the kidneys; it may, however, indicate nasal 
obstruction. 

SHORTNESS OF BREATH— Shortness of breath usually indi- 
cates disease of the heart or lungs. If it is associated with blueness, 
the trouble is usually in the heart. If it is associated with cough, the 
trouble is more likely to be in the lungs. 

SWELLINGS IN THE NECK— These may be due to mumps or en- 
largement of the glands. The swelling of mumps comes on acutely 
and is located just behind, just in front and below the ear. Swollen 
glands are situated lower in the neck, or about the angle of the jaw. 
They may co-me on either acutely or slowly. If acutely they mean 
some acute condition in the throat. If slowly they are most often 
tubercular. They may also be the rsult of irratation of the scalp, or 
lice in the hair. 



GENERAL LASSITUDE, AND OTHER EVIDENCE OF SJCK- 

NESS — These hardly need description, but may, of course mean th^ 
presence or onset of any of the acute diseases. 

FLUSHING OF THE FACE— This usually means fever, and on 
this account should be reported. 

ERUPTIONS OF ANY SORT— All eruptioiis should be called to 
the attention of the physician. It is especially important to notice 
eruptions, as they maye be the manifestation of some of the contagi- 
ous diseases. The eruption of scarlet fever is of a bright red color, and 
usually appears first on the neck and chest, spreading thence to the 
face. There is often a pale ring around the mouth in scarlet fever, 
which is very characteristic. There is also usually a sore throat in 
connection with the emption. 

The eruption of measles is a rose or purplish red, and is in blotch- 
es about the size of a pea. It appears first on the face, and is usually 
associated with running of the nose and eyes. The eiiiption of chicken 
pox appears first as small red pimples, which quickly become stmall 
blisters. 

A COLD IN THE HEAD, WITH RUNNING EYES— This should 
be noticed, because it may mean the onset of measles. 

IRRITATING DISCHARGE FROM THE NOSE— A thin watery 
nasal discharge which irritates the nostrils and upper lip should al- 
ways be regarded with suspicion. It may mean nothing more than a 
cold in the head, but frequently indicates diphtheria. 

EVIDENCES OF SORE THROAT— Evidences of sore throat, 
such as swelling of the n«ck and difficulty in swallovdng, are of im- 
portance. They may mean nothing but tonsilitis, but on the other 
hand may mean diphtheria or scarlet fever. 

COUGHS — It is very important to notice whether children are 
coughing or not, and what is the character of the cough. In most 
cases a cough merely means a simple cold or slight bronchitis. A 
spasmodic cough, that is, a cough which occurs in paroxysm^ iind is 
uncontrollable, very frequently indicates whooping cough. A croupy 
cough, that is a cough that is harsh and ringing, may indicate diph- 
theria. A painful cough may indicate disease of the lungs, espec- 
ially pleurisy or pneumonia. A long continued cough may mean tuber 
culosis of the lungs. 

VOMITING — ^Vomiting usually means some digestive upset. It 
may, however, be the first symptom of many of the acute diseases, 
and should therefore receive attention. 

FREQUENT REQUESTS TO LEAVE THE ROOM— Teachers are 
too much inclined to think that frequent requests to leave the room 
merely indicate restlessness or perversity. They often, however, in- 
dicate trouble of some sort, which may be in the bowels, kidneys, or 
bladder. Such condition should always be reported to the physician. 

THE TEETH 

Unclean mouths promote the growth of disease germs, and cav- 
ities in the teeth are centers of infection. Pus from diseased teeth 
seriously interferes with digestion and poison the system. It causes 
a lowering of vitality and renders mental effort difficult. Diseased 
teeth, temporarily as well as permanent, are often the causes of ab- 
scesses, and should be carefully watched and treated. 

Irregularities of the teeth, especially those which make it im- 
possible to close the teeth properly lead to faulty digestion, to mouth- 
breathing, and to other diseases and evils which an insufficient sup- 
ply of oxygen produces. 

34 



The first peritianent molars are perhaps the most important 
teeth in the mouth, and are the most freqently neglected because 
they are so often mistaken for temporary teeth. It should be remem- 
bered that there are twenty temporary teeth, ten in each jaw, and 
that the teeth that come in about the sixth year immediately behind 
each last temporary tooth — four in all— are the first permanent mol- 
ars. 

The teacher should be on the lookout for pain and swelling in the 
face. When the child keeps the mouth constantly open an examina- 
tion of the teeth should be made. When symptons of indigestion oc- 
cur, or physcial weakness or mental dullness is observed the teeth 
should be inspected. It should be remembered that disease of the 
ears, disturbances of vision and the swelling of the glands of the neck 
may be caused by diseased teeth. 

Children should be instructed that decay of the teeth is caused 
primarily by feiTnentation of starchy foods and sugars, and the great- 
est factor in preventing dental troubles is the removal of food par- 
ticles by frequent brushing. Children should be prevented from 
eating crackers and candy between meals, and \vhen at all possible 
the teeth should be cleaned after meals. Inspection of the teeth by a 
dentist should be jmade at least once in six months. 

A reliable and experienced dentist has told that if children formed 
the habit in early life of brushing their teeth well and rinsing the 
mouth and throat with a warm solution of salt water upon arising in 
the morning, and then brush them again regularly at night with some 
good tooth paste or even with cold water, that the dentist would al- 
most have to go out of business. The salt w^ater hardens and keeps 
the gums healthy, and at the same time is a germicide. 



NERVOUS TROUBLES AND MENTAL DEFECTS 

Teachers and medical inspectors of schools should carefully in- 
vestigate children who sho\y certain physical and mental symptons. 
Especially should the presence of such symptoms be noted in a child 
who did not formerly show them. The most important of these are 
the following. 

1. Restlessness and inability to stand or sit quietly, in a previ- 
ously quiet child, particularly if to this is added irritability of temper 
and loss of self control, as sho\\Ti by crying at trifles, or inability to 
keep attention fixed. 

There may also be present quick, twitching movements of the 
muscles of the trunk, face and especially of the hands, fingers, arms 
or legs. If severe, these may cause the child to drop Vhings, render its 
work awkward, or interfere with buttoning the dothes, writing or 
drawin. Such children are often scolded unjustly for being inat- 
tentive or careless. 

These symptons are the slighter one of chorea (St. Vitus' dance.) 
These should not be confounded with other forms of twitching, such 
as the blinking of the eyelids, the slower twitching movements of the 
face or shoulders, or other parts of the body, often called habit spasms 
which may be due to defects of vision, adenoid growths or other re- 
flex causes. These latter cases do not usually need to be withdrawn 
from school work, though often requiring treatment; while the form- 
er class should be removed from school at once, both for the child's 
sake, and to prevent an epidemic of imitative movements such as some- 
times occurs. 

2. Another class of symptons requiring investigation are repeat- 
ed faintings, especially if the child's lips become blue; attacks, often 
only momentary, in which the child stares fixedly and does not reply 
to questions, or in which he suddenly stops speaking or whatever he- 
SB 



is doing, and is unaware of what is going on about him. These lapses 
of consciousness may be accompanied by rolling of the eyes, droling, 
or unusual movements of the lips, and often appear like a "choking" 
attack. 

Sudden attacks of senseless movements of various sorts, such as 
twisting and pulling at the clothes or handkerchief, fumbling aim- 
lesly at the desk, especially if there is no recollection afterwards of 
what was done, are often another expression of the same condition. 

Such attacks, particularly if repeated at varying intervals, even 
when not accompanied by complete loss of consciousness are frequently 
.as characteristic of epilepisy as the severe convulsions. 

Epileptic convulsions usually involve the entire body in sharp 
jerking move'ments, with blueness of the face or lips, complete loss 
of consciousness and are usually followed by a period of sleep or 
drowsiness, and are frequently accompanied by frothing at the mouth, 
biting of the tonge and occasionally by wetting or soiling the clothing. 

Another class of convulsions is the hysterical, which are often 
difficult to distinguish. The hysterical convulsion, however, differs 
from the epelitic in the following respects. The hysterical patient 
often shouts, cries or raves, not only previous to but frequently thru- 
out the attack, and is often able to reply to questions during: the con- 
vulsion. The epiletic gives a single cry immediately followed by 
unconsciousness and the spasm. The movements in fhe hysterical con- 
vulsion are often accompanied by bowing of the body backward, and 
very frequently simulate intentional or voluntary movements, such as 
tearing the hair, pulling at the clothes, and such things; while the 
epileptic movements are characterized by their jerking or twitching 
character. The hysterical patient, also, in place of a convulsion, may 
strike an attitude, such as of fear or entreaty, often accomp^.neid by 
raving or singing. This again may follow the convulsion, taking the 
place of, and strikingly contrasted with, the almost invariable sleep 
of the epileptic, which is almost never seen in hysteria. Hysterical 
patients if they fall seldom injure themselves by the fall, as epileptics 
frequently do. Biting of the tonge almost invariably indicates an 
epileptic seizure, as does wetting or soiling the clothes when it oc- 
curs. 

Cases of epilepsy, whether mild or severe require treatment and 
advice as to whether they should be removed from school. Many 
cases do not require withdrawal from school, and are benefitted by its 
dicipline. 

3. Excessive nerve fC:<;igue, which is shown by irratibility or 
sleeplessness, may indicate a neurasthenic condition, that is a threat- 
ened nervous breakdown. Such symptons may be due to irregular 
habits, want of sleep, lack of suitable food, poor hygienic conditions, 
or simply from the child being pushed in school beyond its physical 
or mental capacity. 

Excessive fear or morbid ideas, bashfulness. undue sensitiveness, 
causeless fits of crying, morbid introspection and suspiciousness may 
also be sjmiptons of a neurasthetic condition, and call for 'Investiga- 
tion, and for the teacher's sympathy and winning of the child's confi- 
dence, to prevent developments of a more serious nature. 

This nerve fatigue may result in a child being unable for the 
time being to keep up with its work in school. 

Forgetfulness, loss of interest in work and plaj^, desire for soli- 
tude, untidiness in dress or person, and likewise changes of character, 
ara sometimes incidental to the period of puberty, 

4. Mentally defective children in the public schools exhibit cer- 
tain common characteristics. The essential evidence of mental defect 
is that the child is persistently unable to profit by the ordinary meth- 
ods of instruction as shown by lack of progress or failure of promo- 

30 



m 



tion through lack of capacity. After one,two or three years of school 
they are either not able to read at all, or they have a very small and 
scanty vocabulary. One of the most constant and striking peculiari- 
ties is the feebleness of the power of voluntary attention. The child 
is unable to fix his attention upon any exercise or subject for any 
length of time. The monaent his teacher's direction is withdrawn his 
attention ceases. 

These children are easily fatigued by mental effort, and lose in- 
terest quickly. They are not observant. They are often markedly 
backward in number work. They are especially backward in any 
S'chool work requiring judgment and reasoning power. They may ex- 
cel in memory exercises. They usually associate and play with child- 
ren younger than themselves. They have weak will power. They are 
easily influenced and led by their associates. These children may be 
dull and listless, or restless and excitable. They are often wilful and 
disobedient, and liable to attacks of st'abbornness and bad temper. The 
typical "incorrigible" of the primary grades often is a mentally de- 
fective child of the excitable type. They are often desti-uctive. They 
may be cruel to smaller children. They may have untidy personal 
habits. Certain cases with only slight intellectual defects show mark- 
ed moral deficiency. 

The physical inferiority of these defective children is often plainly 
shown by the general appearance. There is generally some evidence 
of defect in the figure, face, attitudes or movements. They seldom 
show the physical grace and charm of normal childhood. The teeth 
are apt to discolor and to decay early. 

It is a most delicate and painful task to tell a parent that his child 
is mentally deficient. This duty should be performed with the great- 
est tact, kindness and sympathy. It would be a great misfortune for 
the school phvsician and the teacher, as well as for the child, to desig- 
nate a pupil as feeble-minded who was only temporarily backward. 

Temporary backwardness in school work may be due to remov- 
able causes, such as defective vision, impaired hearing, adenoid 
growths in nose or throat ,or as the result of unhappy home condi- 
tions, irregular habits, want of proper sleep, lack of suitable food, bad 
hygienic conditions, etc. Great care must always be used not to con- 
found cases of permanent mental deficiency with cases of temporary 
backwardness in school work, due to the causes mentioned above, or 
those described under the head of excessive nervous fatigue. 

In some cases, where the existence of mental defect is in doubt, 
accurate information can usually be found in the early history of the 
child. The time of first "taking notice," the time of recognition of 
the mother, that of beginning to sit up, to creep, to stand, to walk 
and talk should be learned. Marked delay in development in these re- 
spcts is usually found in all pronounced cases of mental d'^ficiency. 

It may also be found useful to require teachers to refer at stated 
intervals to the medical inspectors for examination of all children who, 
without obvious cause, such as absence or ill health show thetoselves 
unable to keep up in their school work, who are unable to fix their 
attention, or are incorrigible — though it does not follow that all such 
eases have either physcal or mental defects. 



Teaching Health 

In seeking to give advice on the subject of teaching health, I feel 
that I can do no better than t-o Quote from the result of deliberations 
of a number of the most practical and successful workers in the healtk 
field, including school doctors, nurses, class room teachers, etc., who 



met in conference to advise in this matter. This conference foi-mulated 
a set of eight rules for "The Health Game", which appear in a health 
bulletin sent out by the Bureau of Education of the Department of 
the Interior, and are: — 

1. A full bath more than once a week. 

2. Brushing the teeth at least once every day. 

3. Sleeping long hours with windows open. 

4. Drinking as much milk as possible, but no coffee or tea. 

5. Eating some fruit or vegetables every day. 

6. Drinking at least four glasses of water a day. 

7. Playing part of every day out of doors. 

8. A bowel movement every morning. 



BE HEALTHY YOURSELF 

"If you would teach health successfully you, yourself, must furn- 
ish an object in health. Measure your efficiency by your enthusiasm. 
Determine to be as nearly 100 per cent physically fit as your natural 
endowments will permit. 

"You need an annual physical examination as much as your pupils 
do. If one is impossible, you can at least weigh yourself once a 
month, and strive to keep your weight near the standard of your age- 
and height. Many teachers are undernourished as a result of bad 
conditions of work, poor boarding places, lack of opportunity for 
regular physical exercise, recreation, etc.; but quite as many from 
failure to obey the simple rules for healthy living which they kn9w 
perfectly well. Obey all of The Rules of the Health Game,' not only 
to inspire your pupils to obey them, but to further your personid 
happiness and ambitions in life. 

"See that your noon lunch is warm and satisfying. 

"See that the room in which you teach is well ventilated. 

"Try to make an opportunity to lie down quietly and relax for 
at least 20 minutes at the noon hour. 



HOW YOU CAN TEACH HEALTH 

"1. DO NOT BE SATISFIED MERELY TO IMPART INFOR- 
MATION ABOUT HYGIENE— AIM TO ESTABLISH HEALTH HA-^ 
BITS. — The essential health habits are as simple as they are iraportant.. 
From the Kindergarten up, their daily practice constitutes the test. 
of successful health teaching. 

"2. 'MAKE TttE CHILD DESIRE HEALTH— Not for its own= 
sake, but as a condition of success ii \York and joy in play. Make 
the acquisition of health interesting and aitracti^e. The pric3 is self 
control in eating and drinking, in wov!v and plav. 

"3.— GET THE HEALTH POINT OF VIEW \OURSELF. and you. 
wdll see and grasp a score of opportunities every day for driving home 
health lessons. Health cannot be taught from text books, or confined' 
to any one lesson period. 

"4.— MAKE YOUR HEALTH TEACHINGS POSITIVE RATHER 
THAN NEGATIVE— Do not say: If you forget to brush your teeth 
they will decay and you will have the toothache; but say, 'Brush your 
teeth regularly so that you may enjoy the feeling of a clean mouth,, 
and have sweet breath and a shining set of strong teeth.' 

"5.— GIVE CREDIT ON THE MONTHLY REPORT CARD for 
the practice of health habits, and ESPECIALLY FOR PRESEVER- 
ANCE IN FACE OF ADVERSE^ HOME CONDITIONS." 

6. Add to the "Rules of the Health Game" other rules appropri- 
ate to the child's physchological development for every year of hi& 
school life. 



TEACHING HEALTH IN THE KINDERGARTEN 

The morning inspection in the kindergarten and in all the grades 
should be made an occasion of joy and interest. It adds to the inter- 
est to have the inspection interspersed with frequent surprises, to 
which children look forward with expectation. "The songs and exer- 
•cisese of the morning greeting in the kindergarten may include the 
showing of clean hands, clean teeth, clean clothing, and clean shoes. 
During the lunch period practical lessons may be given in cheerful, 
courteous table manners, and in the earful protection of the milk and 
crackers. 

"Personal habits which affect others should receive attention from 
the very first. The kindergarten child should be taught how to use his 
handkerchief in coughing and sneezing, and also how" to use the in- 
dividual drinking cups and towels. 

"Fairy tales and other stories which convey health lessons in a 
delightful w^ay may be told by the teacher and subsequently drama- 
tized by the children." 

FOOD TEACHING IN THE PRIMARY GRADES 

We are indebted to Health Education Bulletin No. 6, for the fol- 
lowing practical lessons in a rural school: 

"Oh!, but it's cold today! What do we need on cold days?" 

"We need coal and wood to burn, to keep us warm. 

"Yes, and what kind of fuel do w^e need for our bodies to keep 
ihem warm and get up plenty of steam to make us go?" 

"Oatmeal, eggs, bread and butter and potatoes." 

"The children of her class learned to call foods valuable chiefly 
for fuel and emergy 'go-materials'. Proteins were called 'building 
materials.' The favorite smile for the human body was the automo- 
bile, and the vitamines w^ere called sifmply 'machine oils.' 

"For health and strength we must have iron in our blood. Where 
does it come from?" 

"Out of the ground." 

"Can we dig it out of the ground and eat it?" 

"No." 
"But vegetables send their roots down, down into the ground and 
absorb iron into their stems and leaves. How, then, can we get the 
iron?" 

"Why, eat the vegetables, of course." 

Also this: 

HEALTH CORRELATION WITH STUDIES IN INTERMEDIATE 

GRADES. 

"ENGLISH — Have the children dramatize health stories which 
they have read, or let them make up their own plays or lines. Have 
them write compositions or reproductions illustrating many applica- 
tions of their health knowledge 

"DRAWING— Make posters illustrating such slogans as "The Milk 
Way is the health Way' or 'An apple a day keeps the doctor away.' 

"Make illustrations of good and bad posture and of beautiful, 
sinnimetrical human bodies. 

"ARITHMETIC— Work out the comparative costs of different 
kinds of food and their relative food values. Compare the cost of 
raw foods and of cooked foods as sold at the school lunch counter 
and at public restaurants. Consider the cost and value of careful san- 
itary handling of foods. 

"If you buy clean milk froim the dairy at 17 cents a quart, and 



unsafe milk from a dirty dairy costs 15 cents a quart, how much do 
you pay a year for safe milk. Is this form of health insurance worth 
while? Why? 

"If John earns $25 a week, and he gets typhoid by dirty milk 
and has to give up his job for ten weeks, how much does he lose in 
salary alone on account of unsafe milk?". 

"CIVICS — Study the connection between personal and public' 
health matters. Inspect bakeries, cold storage warehouses, 'meat mar- 
kets, dairies, creameries, grocery stores', and other places where foods 
are prepared and sold, or stored, in order to find out whether they are 
being conducted in accord with the laws designed to protect the health 
of the public. Learn about different occupations and their effect on 
health, as an element in the wise choice of vocation. Learn what the 
government and STATE are doing, and what they ought to do to pro- 
tect the health of workers in mines and factories. Learn to know the 
lives of its great .generals, like Pasteur, Walter Reed, Gor^as, or Tru- 
deau. Learn how yellow fever was stamped out in Panama; how the 
fight against tuberculosis is being staged /today, and how everybody 
can have a share in winning the great battle. 

"GEOGRAPHY— Stud-/ the home life, the food habits, and sani- 
tary customs of other races in many lands, under differing conditions 
of climate and civilization. Compare them with our own. Study food 
production and cost. 

"HISTORY — Emphasize the feats of strength and of endurance of 
the savage Indians. Show how some great military leader depended 
for h;is success on steady nerves and a body hardened. Show the value 
of a strong body in the attainment of success in business and politics. 
Tell how Theodore Roosevelt developed his body." 



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Aims of the Health Department 
of Oklahoma are: 



To educate the parents in every home in Oklahoma to conserve 
their own health and that of their children. 

To enlighten the minds of children to the extent that they will be- 
come interested in sanitation and personal hygiene, and form habits 
of kealth and hygiene while their minds are yet plastic. 

To reduce the death rate among infants and children and reclaiim 
them for useful, happy lives. 

To furnish free prophylactic remedies for use in the eyes of new- 
bom babies, and to make the use of same compulsory. 

To supply antitoxin typhoid prophylactic, smallpox vaccine free to 
all in need of same and not able to pay therefor. 

To have all children examined for physical defects, contagious and 
infectious diseases and reports sent to parents with the request that 
they call on their family physician and secure advice and treatment. 

To have a full time County Health Officer and public health nurse 
in every county. 

To know that every baby's birth has been registered with the 
State Registrar of Vital Statistics. 

To be of real and lasting service to the people of Oklahoma. 



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department of public ^nstructunt 

R, H. WILSON. SUPERINTENDENT 
E. N. COLLETTE. ASST. SUPT. 

(l^klal|oma Cttg 

August 19, 1920 

To the Teachers and Patrons of the 
Public Schools of Oklahoma: 

We are very much interested in improving the health and sani- 
tary conditions surrounding our schools and homes. It has been my 
observation that a great deal of time has been lost by the pupils in 
the schools, as well as others, because of what seems to be an entire 
disregard for the simplest laws of health. It has been the policy of 
Oklahoma to build up an efficient and serviceable Health Department, 
the duty of which is to look after the <^eneral health conditions of the 
state. Wonderful results have been accomplished along this line, but 
so much more could be accomplished if each and every teacher in our 
great state would become personally interested in this matter and 
teach these principles to the children in the schools. To this end, we 
have asked Dr. A. R. Lewis, State Comimissioner of Health, to have a 
sufficient number of bulletins printed to furnish each teacher a copy, 
and we most earnestly request that this bullentin be used in your 
school in connection with the Physiology, and that credit be given to 
the children for making health surveys in their local communities. 

I have suggested that a card be inserted in this bulletin which 
should be filled out by the teachers and mailed to Doctor Lewis giving 
him certain information with reference to your school, in order that 
he may be able to help you if assistance is desired, or that he may know 
if you are so fortunate as to be located in a school where proper pre- 
cautions are taken to protect the health of the pupils. 

Your active co-operation in this matter will be appreciated by 
Doctor Lewis, as well as by myself. 

Yours sincerely, 

R. H. WILSON, 
State Superintendent of Public Instruction. 



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